Gastrointestinal Cancer - GI

At the Feist Weiller Cancer Center, we treat and manage cancers of the digestive system. The digestive system is where food is processed to create energy and remove waste from the body. Gastrointestinal (GI) cancer is the abnormal growth of cells which lead to tumor formation in the esophagus, stomach, liver, biliary system, pancreas, intestine, colon, and anus.

Types of Gastrointestinal Cancer

Esophageal cancer

Food travels down the esophagus from the mouth to the stomach. Cancer forms tumors in this muscular organ by uncontrollable cell growth and division. This cancer has the ability to metastases to surrounding organs and tissues such as the lungs, lymph nodes, and stomach. Types of esophageal cancer include squamous cell carcinomas, adenocarcinoma, small cell neuroendocrine cancer, lymphomas, and sarcomas. Of these the most common are squamous cell carcinoma developing from the squamous cells lining the esophagus, and adenocarcinoma developing from tissue making up glands in the esophagus. Patients with esophageal cancer have 16% chance of surviving five years. Studies have shown that this cancer is one of the top ten leading causes of cancer death in the United States. Risk factors include age (between 45-70), gender (found more often in men than women), race ( found more often in African Americans than Caucasians), use of tobacco products, abuse of alcohol, obesity, occupational hazard of ingesting lye, reflux disease (Barrett’s esophagus), achalasia, or having diets low in vegetables and fruit. Symptoms that may occur are pain or difficulty swallowing, coughing, heartburn, unintentional weight loss and hoarseness. Patients having these risks and symptoms should pay close attention to their body and contact a physician for evaluation.

Gastric cancer

Food in the stomach is broken down by gastric juices and the churning of stomach muscles. Gastric cancer is found in all areas of the stomach and can metastases to surrounding organs and tissues such as the lungs, liver, colon, pancreas, and ovaries. Adenocarcinoma (the most commonly found), lymphoma, gastric sarcoma, and carcinod tumors are gastric cancer. Before metastases patients have a 62% chance of surviving 5 years. Risk factors include age (most diagnosed between 60 and 70), gender (men diagnosed more often than women), race (African Americans diagnosed more often than Caucasians), occupational hazard of ingestion of dust or fumes, use of tobacco, abuse of alcohol, obesity and genetic disorders (Hereditary non-polyposis colorectal cancer, HNPCC and Familial adenomatous polyposis, FAP). Symptoms that may occur are heartburn, abdominal pain, low appetite, blood found in stool or throw-up, unintentional weight loss, fatigue, and nausea. Patients having these risks and symptoms should pay close attention to their body and contact a physician for evaluation.

Pancreatic Cancer

The pancreas is a gland in the abdomen that functions in two ways exocrine and endocrine. Enzymes, that help to digest fats in food, are releases through ducts from into the small intestines from the pancreas by the exocrine function. Cells in the Islets of Langerhans produce insulin to control blood sugar by the endocrine function. The different types of pancreatic cancer include ductual adenocarcinoma, islet cell tumors and neuroendocrine. Pancreatic cancer has the potential to metastases to other organs and tissue such as abdominal lining, liver, or lungs. Studies have shown pancreatic cancer to represent the fourth leading cause of cancer death in the United States. Patients have a 26% chance of surviving one year and 5% chance of surviving five years after diagnosis. Surgery brings the five year survival chance to 20%. Risk factors include age (60 and older), gender (African American diagnoses more often than Caucasians, Hispanics, or Asians), obesity, diets high in fat, type 2 diabetes, family history of pancreatic cancer, chronic pancreatitis, hereditary pancreatitis, use of tobacco, and abuse of alcohol. Specific symptoms of pancreatic cancer are not certain. Patient with risk of pancreatic cancer should pay close attention to their body and contact a physician for evaluation.

Small Intestines Cancer

The small intestines made up of the duodenum, jejunum, and ileum, are connected to the stomach and colon (large intestines). Food is broken down further and nutrients are absorbed here. Different types of small intestine cancer include adenocarcinoma, sarcoma, gastrointestinal stromal tumor (GIST), carcinod tumors, and lymphoma. Of these, adenocarcinoma, found in the upper part of the small intestines involving glandular tissue, is the most common. These cancers have the potential of metastases. The survival rate of patients with cancer of the small intestines is not definitive. Risk factors include diets high in fat, Crohn’s disease, Celiac disease, and Familial adenomatous polyposis (FAP). Symptoms that may occur are diarrhea, an abdominal mass, abdominal pain or cramps, unintentional weight loss, nauseas, vomiting, and black stools with or without the presence of blood.

Liver Cancer

Some of the important functions of the liver are removal of toxic wastes from the body, helps to maintain proper balance of sugar in the blood, produces bile, and stores nutrients collected from the intestines. Primary cancers of the liver are Hepatocellular carcinoma (HCC), Cholangiocarcinoma, and Angiosarcoma, while secondary cancer are cancers that have spread to the liver from other sites. Patients with liver cancer have an estimated 10.5% chance of surviving five years after diagnosis. Studies have shown that liver cancer is the 6th leading cause of cancer deaths in the United States. Risks factors include cirrhosis, age (60 and older), gender, (seen more often in men) and environmental factors (exposure to chemicals and aflatoxin mold). Symptoms include abdominal pain, unintentional weight loss, mass found under the right side of the rib cage, fatigue, abdominal swelling, and enlargement of the liver. By limiting the use of alcohol, protecting yourself from infection of viral hepatitis, and having screenings if diagnosed with cirrhosis, liver cancer can be prevented.

Colorectal Cancer

The large intestines are made up of the colon and rectum, while the colon is further made up of the ascending, transverse, descending, and sigmoid colon sections. The colon receives food from the small intestines that has been devoid of nutrients. It further manipulates the food by absorbing water and making it ready to leave the body. Colorectal cancer first starts as a benign polyp found on the inside lining. Adenocarcinoma, carcinoid tumor, gastrointestinal stromal tumor (GIST) and lymphoma are some of the cancers of the colon and rectum. Studies have shown colorectal cancer to be the second leading cause of cancer death in the United States. Patients with early stages have a 90% chance of surviving 5 years after diagnosis. Patients with metastases colorectal cancer to the surrounding lymph nodes and organs have a 68% chance of surviving five years, while those with metastases to further body parts have a 10% chance of surviving five years after diagnosis. Risk factors include having adenomatous polyps, age (50 and over), inflammatory bowel disease, personal history of cancer, family history of colorectal cancer, obesity, low rate of exercise, use of tobacco, regular use of non-steroidal anti-inflammatory drugs, and race (African American are diagnosed more often with colorectal cancer). Symptoms include diarrhea, constipation, unintentional weight loss, fatigue, altered bowel movements, extreme red or black stools, iron-deficiency anemia, abdominal cramps, and abdominal swelling. Patients starting at 50 years old should have regular screenings for the detection of polyps and colorectal cancer. Some of the tests used for screening are fecal occult blood test (FOBT), flexible sigmoidoscopy, colonoscopy, and double contrast barium enema (DCBE).

Anal Cancer

Anal tumors can start as noncancerous polyps, warts, or growths. Patients with early stages of anal cancer, later stages, and metastases have 82%, 60%, and 19% probability of surviving five years after diagnosis of anal cancer. Risk factors are Human papillomavirus infection (HPV), age (50-80), anal fistulas, use of tobacco and immunity compromised by HIV, organ transplant, or immunosuppressive drugs. Symptoms include presence of an anal mass, bleeding, pain, itching, discharge, and swelling of the anus. Anal cancer and be prevented by abstinence from anal intercourse and using condoms during sexual intercourse to protect against HIV and HPV. Screening for anal cancer using anal cytology may help to find anal cancers in early stages for best treatment results.

Prevention Measures

We are not sure the best way to prevent GI cancer. Preventive measures include avoiding or limiting alcohol use, avoiding tobacco use, consuming a diet high in vegetables, fruits, and whole-grain foods, avoiding high salted, pickled, and smoked foods, limiting red meat intake, consuming a low fat diet, and participating in an exercise program. Your diet should include at least five fruit and vegetable servings a day. Many daily lifestyle choices may decrease your risk of developing cancer.

Tests & Diagnosis

Diagnostic procedures include a colonoscopy (to view the lower GI tract) and an esophagogastroduodenoscopy or EGD (to view the upper GI tract). Computed tomography (CAT) scan combines X-ray images with computers to produce a highly detailed cross-sectional picture of the body. Magnetic Resonance Imaging (MRI) uses a magnetic field instead of X-ray images to develop an image of the body. X-ray contrast studies view the GI system from the pharynx to the rectum and detect mass lesions or abnormalities. Endoscopic ultrasound can provide the depth and extent of a lesion. A biopsy is the removal of cells or tissue for examination.

Treatments

Your oncology team consists of medical oncologists, radiation oncologists, and surgical oncologists. They all collaborate together to plan the best treatment plan for each individual. The medical oncologist initiates chemotherapy which is medications that kill cancer cells. The chemotherapy medications may be given by mouth, intravenously (through a vein), or intramuscular (in the muscle). We offer a wide range of chemotherapy treatment options depending on each individual case. Your medical oncologist will also make any adjustments to your treatment plan as needed, answer any questions, and explain complicated issues that may arise. A radiation oncologist uses radiation therapy which is high energy X-rays that kill cancer cells or inhibit them from growing. A surgical oncologist is specialized in performing surgery to remove cancerous tumors. Surgery depends on the size, location, and extent of the tumor. Each treatment plan is targeted to each individual and may differ from another treatment plan. 

Advanced Science & Research

We are continuously participating in clinical trials and research for our gastrointestinal cancer patients. Newly developed treatments or investigational drugs can also reduce tumor size and eliminate symptoms. Patients are voluntarily asked to participate in our research trials to evaluate new cancer prevention and treatment choices.

Clinical Trials

We are actively participating in clinical trials and research for our cancer patients. Newly developed treatments or investigational drugs may reduce tumor size and eliminate symptoms better than treatments currently available.

Patients are asked if they would like to participate in our clinical trials to evaluate new cancer prevention and treatment choices. Participation is completely voluntary. Ask the doctor about clinical trials at your visit.

See the patient information on Clinical Trials at the Feist-Weiller Cancer Center. Additional information is available for medical professionals.  For more information about ongoing clinical trials at the Feist-Weiller Cancer Center, please call us toll-free at 1-866-LSU-FWCC (578-3922) or (318) 813-1410.

Cancer Support Group

The Feist Weiller Cancer Center offers two patient support groups, meeting once a week, for all types of cancer. For more information about these two support groups, please call:

Jo Ann Stewart, RN at (318) 813-1409
Susie Wiggins, RN at (318) 813-1417
Ron Nierman at (318) 470-6180

Genetic Testing and Counseling 

Almost all of us have known someone with cancer, be it a colleague, friend, or family member. For many, these acquaintances are few, and family occurrences sporadic, but for some families, cancer appears to have a much higher prevalence and may be passed throughout many generations. Our expanding knowledge regarding the hereditary aspect of cancer has enabled genetic counselors, nurses, and physicians to provide risk counseling to patients; and advances in genetics have allowed us to develop tests that help to pinpoint this hereditary risk. 

At the Feist-Weiller Cancer Center, the Hereditary Cancer Risk Assesment Program performs an initial cancer risk assessment for all patients by recording a complete family history and creating a pedigree in which all affected relatives are shown. If the patient has a positive family history of cancer, he or she is referred for genetic counseling in order to determine if genetic testing is the next appropriate step. Once genetic testing is completed, patients receive an additional counseling session in which results are disclosed and discussed. If a patient tests positively for a given mutation, specific surveillance and preventive options, as well as additional genetic testing for other family members, are discussed.

If a genetic mutation is detected in at-risk individual, which predisposes him to development of a hereditary cancer syndrome, this information is crucial in guiding the future medical and surgical management of this individual. In addition, certain hereditary cancers have unique behaviors at both a clinical and molecular level, and detection of specific mutations may help to guide therapy for these types of cancer. Discovery of a mutation specific for a hereditary cancer syndrome is not only helpful in guiding future management of that individual, but it also provides useful information about disease risk in other family members, and also the risk of the affected individual passing the mutation to his or her unborn offspring.